Long-term Sequelae in Children With Invasive Meningococcal Disease, Chile 2009–2023

BACKGROUND: Around 30% of survivors of invasive meningococcal disease (IMD) may develop long-term sequelae; data from Latin America remain scarce. This study aimed to estimate the proportion of long-term sequelae in pediatric IMD survivors and associated factors. METHODS: A retrospective cohort study with cross-sectional outcome evaluation included children diagnosed with IMD (2009-2019) in 2 hospitals in Santiago, Chile. Between October 2022 and April 2023, 40 IMD survivors and 42 age- and sex-matched children without IMD or central nervous system infection underwent standardized physical, neurocognitive, audiologic and functional assessments conducted independently. Prevalence ratio (PR) and adjusted PR (aPR) were estimated with modified Poisson regression with standard errors. RESULTS: Median ages were 10 (interquartile range [IQR] 9-13) and 11 (IQR 9-14) years in the exposed and unexposed groups; 70% and 64.3% were male. Sequelae occurred in 70% of exposed; the corresponding clinical findings were present in 16.7% of unexposed children (PR, 4.20; 95% confidence interval [CI]: 2.07-8.51). Neurologic (55%), dermatologic (25.0%) and hearing (20.5%) sequelae predominated. This association remained significant after adjusting for age, sex, caregiver education and socioeconomic status (aPR, 3.75; 95% CI: 1.83-7.69). Children with sequelae had a lower quality of life than those without sequelae (62% and 8%, P = 0.004). CONCLUSION: Pediatric survivors of IMD in Chile face a high burden of long-term sequelae. Sustained multidisciplinary follow-up and preventive strategies, including vaccination, are essential to reduce disability and improve quality of life.